Academic investigates the relationship between the nervous and immune systems after the Irritable bowel syndrome
Caroll Beltran, researcher at the Department of internal medicine North and attached to the service of Gastroenterology of the Hospital Clinic of the University of Chile, It is after this evil response highly prevalent in our country, popularly known as “irritable bowel syndrome”
Famous irritable is the most prevalent of the functional digestive disorder, says the academic. "From the" 2016, is defined as a disorder belonging to the Group of digestive disorders that involve changes in the gut axis, manifested by aches and pains the gastrointestinal tract and which are strongly linked with a psychosocial component or nervous”, destalló academic Carol Beltran.
Irritable Bowel Syndrome (IBS), known as irritable bowel syndrome-although it encompasses all of the intestine-, According to add the researcher, “It is one of the most important from the perspective of the prevalence, as in Chile preliminary studies indicate that it affects to approximately the 28 per cent of the population, mostly women".
The problem, Add Beltran-PhD in Sciences Biomedical of the Faculty of Medicine of the University of Chile and postdoctorada in Neurogastroenterologia of the APC Microbiome Institute, University College Cork, Ireland- the research behind this evil is scarce, to the extent that There are diagnostic markers, being identified in clinical practice by exclusion; I mean, When has any organic dysfunction already dismissed. "Patients, dissatisfied with this situation, they go to the doctor with the results of numerous tests, most normal". The SII is described at the international level - according to the standard Rome IV- as the presence of abdominal pain associated with defecation, which occurs at least once a week for a minimum of three consecutive months.
A psychosocial problem
This disease, added the specialist, “presents mechanisms that are not fully resolved and involve the biosocial sphere; I mean, by the social and psychological component of the individual, What speaks there is a nerve connection affecting the biological system of significantly. There are data showing that major childhood trauma, even from birth, affecting the plasticity of the nervous system and the axis hypothalamus pituitary adrenal gland, leading to immune and nervous disorders, that in the future you trigger this syndrome of irritable bowel syndrome”.
That is why, added Beltran, It will delve into this research - funded by Fondecyt Regular-, “in the nervous and immune communication, i.e. how this altered nervous system develops responses on the immune system of anomalous way. Our results, from parallel investigations in course, They show us that high levels of anxiety and depression are present in our study population”.
Vicious circle at the molecular level
One of the key players in this disease are mast cells. These correspond to cells that originate from a bone marrow stem cell, they differ in tissues and act in the mediation of inflammatory and allergic. "This mast cell, in the SII responds by nerve activation, and does it degranulando be or secreting certain proteases and chemical mediators of selectively, not anaphylactic, It is not as a reaction to an allergy", explained Dr. Beltran.
These proteases, added, they will have a wide action within the intestinal mucosa, but particularly with a receiver of their epithelium called PAR2, which is going to cut and activate. And this enabled PAR2 is related to an increased permeability of the intestinal epithelium, is this tissue loses its capability of barrier, What - in a kind of vicious circle- most active mast cells and other components of the immune system adjacent to the epithelium. "It's all inflammatory mechanism that would be triggered by a permanent nerve response in the gut".
On the other hand, in an earlier project, that constituted his Fondecyt's initiation, the researcher discovered that patients with IBS have a degree of non-severe intestinal inflammation - such as in the case of individuals with Crohn's disease or ulcerative colitis- and, In addition, they have high expression in a protein called Bcl3 in the intestinal epithelium, that may be slowing down the immune response, which would explain that the inflammatory response in pictures of irritable bowel syndrome was not excessive.
In this new study, the academic expected to describe the role of Bcl3 as part of a protein complex with NFkB, in the control of certain DNA transcripts, as in the case of Inflammatory Cytokines and proteins involved in the close union - or tight junction- epithelial. "I think that Bcl3 affects the transcription of genes that are related to the stability of the unity of the intestinal epithelium, What happens when it slows down white the NF gene expressionkB".
For this reason, sentenced, in the molecular "I intend to elucidate whether PAR2 affects the expression of Bcl3, describing the signaling pathways that lead to the increase and activation of Bcl3, as well as its impact on the unity of the epithelial cells".
The power of the psychosocial intervention
At the same time, says Dr. Beltran, biological samples obtained during its earlier draft be added which obtain new patients with IBS, who also apply a battery of surveys and psychological interviews to determine this disorder-related psychosocial factors.
"Do not I can scan an isolated mechanism if not I check in addition as they are studying other factors around this central processing. I mean, We will determine psychosocial aspects and General inflammatory aspects of individual, because everything is within the same thing: how psychosocial stress affects the physiological state of the intestine, by inducing changes in microbiota, the integrity of the intestinal barrier and the State of the immune activation, mainly mast cells”
With respect to this process, completed, they have obtained promising results thanks to a recent psychosocial intervention performed on a small number of patients with irritable bowel syndrome. "We made them eight sessions of stress management through Mindfullness, It is an education program that is based on Buddhist meditation, changing the confrontation of stress to full attention at the present time and that it is already well known and approved. We evaluate your psychological and clinical behavior and saw that after these sessions they decreased the severity of the symptoms and improved their levels of anxiety and depression, In addition to the showdown, perception and stress management. And, at the molecular level, We are looking at what happened with interleukin levels 6, the effects that we will soon publish".
Cecilia Valenzuela León/ Photographs: David Garrido